how often do cancer patients get ct scans

asked by: Steve Snodgrass; Bowling Green, Kentucky. Many patients also demand them. A test to detect CEA in the blood can be used to tell if colorectal cancer may have returned. However, the lifetime risk of cancer from a single CT scan was small—about one case of cancer for every 10,000 scans … Within 3 years after surgery, the high-intensity group received a CT scan and CEA assay 5 times each, while the low-intensity group received both tests twice. To make CT scans safer, providers use X-ray shields to protect sensitive areas and adjust doses to minimize the risk for younger patients. These tests include chest CT scan or X-ray. Physicians tend to "over-image" with costly radiologic and nuclear medicine tests. I should also mention that unless contraindicated, we treat the patient with bone-only breast cancer with a bisphosphonate to harden the bones. Dr. Otis Brawley CT scans provide critical information. Imaging tests (or scans) are ways to create pictures of the organs and tissues inside the body. 12/19/16- PET scan 5/5/17-CT scan 11/16/17-CT scan 5/11/18-PET scan He will have another CT in 6 months, and then a second one 6 months later. There is … To try to detect recurrences as early as possible, people who have finished colorectal cancer treatment regularly return to their doctors for imaging tests (like CT or MRI scans) and a blood test to detect CEA, a substance that can indicate if cancer is growing. Government panel: Hormone therapy 'not recommended'. If one is taking the medical oncology board exam, the answer is bone-only metastatic breast cancer that is being treated with hormones or that has been treated with chemotherapy and is now quiet should be followed with regular questioning of the patient about symptoms, physical examination and some blood tests to assess bone turnover, liver and renal function. Conditions Expert Follow-up tests can be a psychological and financial burden on patients. After 5 years, they are typically done about once a year. In addition, there was no difference in deaths overall or deaths from colorectal cancer between the two groups, the researchers found. Although these new studies are important, they do have limitations, Dr. Sanoff pointed out. These PET scans allow the doctor to determine how well the patient's cancer is responding to treatment. American Cancer Society. Guidelines vary in their advice to doctors about how often patients should get these imaging tests. Have I drunk enough to cause liver cirrhosis? However, current medical guidelines differ on the recommended surveillance tests and how often they should be performed. This type of scan takes a series of x-rays and uses a computer to put them together. Gerry consulted with us after 6 months on chemotherapy for stage 3 lung cancer that had been diagnosed based on a CT scan.. What determines how often to get CT scans after chemo for Ovarian Cancer? Before your scan … Physicians will often perform a follow-up PET scan on people undergoing treatment for cancer. A chest X-ray and X-ray of the area of metastasis (spread to bone) would also be useful. Also, due to the volume of comments we receive, not all comments will be posted. Comments are moderated by CNN, in accordance with the CNN Comment Policy below, and may not appear on this blog until they have been reviewed and deemed appropriate for posting. These tests often find health problems that are not serious. BackgroundMany different types of tests are used to help diagnose cancer, determine the cancer’s stage, monitor how well treatment is working, and watch for a cancer recurrence (return of the cancer). “I think we will end up risk-adapting guidelines as we learn more,” he said. Therefore, cancer patients should be checked according to the needs of the disease. Many patients also demand them. But cancer … “Multiple factors, such as the aggressiveness of surgical resection at an individual facility, might influence these outcomes other than surveillance frequency,” she wrote. You may not post any unlawful, threatening, libelous, defamatory, obscene, pornographic or other material that would violate the law. All comments should be relevant to the topic and remain respectful of other authors and commenters. What makes CT scans more of a threat than even X-rays has to do with the way they deliver radiation. But for people who have been treated for colorectal cancer and who have certain risk factors that increase the risk of recurrence, more intense surveillance might be appropriate, Dr. And because the trial was conducted in Europe, another question is “whether the findings apply to the US population, with our diet and exercise habits,” said Dr. Nor did they find a significant difference in rates of treatment for cancer recurrence between patients who were tested at high- and low-intensity facilities. … In practice, many doctors do CT scans of the body and pelvis every few months; others do nuclear medicine tests such as PET scans or bone scans. So, you’re probably not missing that window of opportunity” by doing surveillance tests once a year, he said. by NCI Staff, October 14, 2020, Chief Medical Officer, Asked by Claire Myers, Rockledge, Florida. “The message for survivors is one of reassurance,” Dr. Chang said. Dr. Chang’s study compared the outcomes of patients who got tested at a high- or low-intensity facility, rather than comparing the outcomes of patients who received high-intensity or low-intensity testing, Dr. Sanoff noted. This will mean that I will have 2 CT scans … There is no recommended limit on how many computed tomography (CT) scans you can have. They also can be used following a CT scan to determine whether a suspicious-looking area is scar tissue or active cancer. In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “Do Frequent Follow-Up Tests Benefit Colorectal Cancer Survivors? Undergoing follow-up testing for cancer recurrence more than once a year may not benefit people who have been treated for colorectal cancer, results from two new studies show. Biosimilars for Cancer Emerge as Patents on Widely Used Biological Drugs Expire, Approval Expanded for Venetoclax in Chronic Lymphocytic Leukemia, If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. I use pamidronate (trade name Aredia) or zoledronic acid (trade name Zometa). CT scans provide more-detailed images of more types of tissue than traditional X-rays do, which allows your doctor to detect and locate many medical conditions.. CT scans … ( 6 ) Other studies have calculated that the risk of a single CT scan causing cancer … This difference seemed to be attributable to patients … “The data [from these studies] should definitely force us to get back together as a group and think about whether we need to revise the guidelines,” said Blase Polite, M.D., an oncologist at the University of Chicago Medical Center. CNN Comment Policy: CNN encourages you to add a comment to this discussion. Continued Some organs are more sensitive to radiation than others. But in some patients, the cancer will return, usually within 3 years after surgery. The study, called COLOFUL, was led by Peer Wille-Jørgensen, D.M.Sc., of the Danish Colorectal Cancer Group. In an attempt to quantify cancer risks from CT scans, the National Research Council in 2006 calculated that every 10 mSv of radiation exposure increases the lifetime risk of cancer by 0.1 percent. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. After cancer treatment is complete, the healthcare provider may want the patient to undergo periodic PET scans to determine if the cancer … After 5 years, the rate of detected cancer recurrence was unchanged between the high-intensity group and the low-intensity group. This may decrease risk of broken bones and may also fight the cancer by making it more difficult for the cancer to implant in bone and grow. What the results from these two studies reveal, said Dr. I have metastatic breast cancer, so far in bones only. The National Comprehensive Cancer Network, for example, recommends that people who are treated for stage II or III colon or rectal cancer have CEA testing every 3 to 6 months for 2 years and then every 6 months for 3 additional years, plus CT scans every 6 to 12 months for 5 years. Like other X-ray imaging exams, CT scans expose you briefly to a small, targeted amount of ionizing radiation. The findings were similar when the investigators stratified participants by cancer stage. By submitting your question, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your questions(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. Also, PET, and especially PET-CT scans… However, CT scans also expose patients to 100 to 500 times more radiation than other types of x-ray imaging. CEA every 3 months for the first year, then every 6 months … Today I found out that the Mayo Clinic wants to do a CT scan and an MRI of my brain. The radiation helps create an image of structures inside your body. Can a nerve stimulator stop my back pain? I know of a few patients who have had stable disease for more than 20 years. CNN Privacy Statement.The information contained on this page does not and is not intended to convey medical advice. Based on the findings of these and other studies, “there is now a considerable body of evidence that imaging and CEA testing more often than every year does little to improve survival in a meaningful way,” wrote Hanna Sanoff, M.D., of the University of North Carolina at Chapel Hill, in an editorial on the two studies. Studies every three months can be quite expensive and expose the patient to a hefty dose of radiation. was originally published by the National Cancer Institute.”, November 10, 2020, Whenever I go to see doctors other than my oncologist, they want to know about when and how often additional testing and/or scans are performed. On average, patients who were initially treated for advanced stage colorectal cancer received more tests. Polite added. But cancer care guidelines generally do not recommend a PET scan be used as a first-line test for determining if the cancer … It sounds like you have an orthodox oncologist who follows the rules and does not over-image. In practice, many doctors do CT scans of the body and pelvis every few months; others do nuclear medicine tests such as PET scans or bone scans. A friend who finished chemo in October for same Ovarian and same stage III, has not had any CT scans … “They don’t have to get a CT scan at every follow-up visit.”. The American Society of Radiology holds that individuals can receive a cumulative maximum dose of 100 mSv for normal diagnostic imaging scans … I had a CT scan with contrast two days ago at my “home” hospital. March 31, 2009 -- As many as 7% of patients treated at a large U.S. hospital received enough radiation exposure from repeated CT scans to increase their cancer risk, according to a new … Both of the new studies aimed to determine whether increased surveillance improved outcomes of colorectal cancer, but they took different approaches. PET and PET-CT scans have risks. Your question actually speaks directly to one of the controversies in medicine today regarding medical costs in the United States. Different types of scans are often used at different points in a person’s cancer … Having PET and PET-CT scans can add to your stress as a cancer survivor. Guidelines may recommend imaging tests every 3, 6, or 12 months after surgery… After a median follow-up period of 79 months, patients followed with chest CT scan had a significantly longer overall median and 5-year survival (P = .0009) than those followed by physical examination and CXR (hazard ratio,1.279; 95% CI, 1.086-1.507). Is the inability of cancer patients to eat a concern? If your risk of the cancer coming back is higher, you might have a CT scan at: 6 months; 1 year; 2 years; 3 years; 5 years; every 2 years onwards; The risk of the cancer … Previous question:Have I drunk enough to cause liver cirrhosis?« Back to Conditions. For example, she noted, the COLOFUL trial investigators modified the design of their study to increase enrollment and aid trial completion. Mine was 3B- and with us "threes" the standard is- CT yearly, I believe for 3 years? Overall survival was also unaffected by the intensity of surveillance. The report found that CT scans are often overused and conducted at higher … The emphasis during follow-up should be not only on recurrence detection, but on the entire survivorship experience, he added. Doctors often order PET scans to stage a cancer or to assess whether treatment is working. At high-intensity surveillance facilities, patients received an average of 2.9 imaging tests and 4.3 CEA tests in 3 years. Please consult a physician or medical professional for personal medical advice or treatment. Although some patients may prefer more frequent surveillance for peace of mind, the tests are not without harms, Dr. Chang pointed out. Before your next CT scan. The first group I had did the scans every 6 months for the first three years. For people who are diagnosed with colorectal cancer that has not spread to distant locations in the body, surgery can cure most patients. The goal of follow-up testing, or surveillance, of people who have been treated for cancer is to improve patient survival by detecting and treating a recurrence early. The longer you have been free of cancer, the less often the appointments are needed. You may not post any unlawful, threatening, defamatory, obscene, pornographic or other material that would violate the law. The researchers used the database and additional information regarding surveillance testing and recurrence to track the patients’ care for a minimum of 5 years, beginning with their cancer surgery. This encompasses monitoring people who have undergone cancer treatment for toxicities from their treatment, counseling them about leading a healthy lifestyle, and providing them with appropriate resources for psychosocial support and management of financial toxicity when needed. That will put him in year 3. Cancer recurrence was not detected earlier in patients who were tested at high-intensity facilities, regardless of cancer stage, Dr. Chang and his colleagues found. Why CT scans are worse than X-rays. In a patient who is in good physical shape, I do this every three months with the advice to come in sooner if you have any worries. When a severely ill patient has undergone several CT exams, the exams … Individuals who have had multiple CT scans before the age of 15 were found to have an increased risk of developing leukemia, brain tumors , and other cancers in the decade following their first scan. He will then we believe go on to yearly PET scans … There is no evidence that these tests and early detection of tumor growth benefit the patients, but many doctors do them anyway. Play it safe by asking the following questions next time a doctor prescribes a CT scan … Polite. He was scheduled to have numerous additional chemo treatments, but he was confused and reluctant to do so – because, aside from some side effects after the chemo treatments, he felt perfectly fine...no symptoms at all. A slow-growing colorectal cancer “probably isn’t going to change all that much between year 2 and year 3. The same researchers also noted huge variability in how much radiation patients get, with some patients … I have decided to go to the Mayo Clinic for an assessment and second opinion and my appointments are in two weeks. You are solely responsible for your own comments, the consequences of posting those comments, and the consequences of any reliance by you on the comments of others. Voiceover: A CT scan helps your doctor make a diagnosis, decide about what treatment you need or find out if your treatment is working. Based on their findings, Dr. Chang and his colleagues agreed with the surveillance recommendations of the National Institute for Health and Care Excellence in the United Kingdom: In the first 3 years following initial surgery, people who have been treated for colorectal cancer should receive CEA testing every 6 months in addition to two CT scans.Although some patients may prefer more frequent surveillance for peace of mind, the tests are not without harms, Dr. Chang pointed out. By submitting your comment, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your comment(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. Physical examination and CEA testing every three to six months Abdominal and chest CT scan each year (every six to 12 months for patients with a high risk of recurrence) For patients with … Rather than simply capture a two-dimensional plot of a person’s insides, a CT scan … I think it mostly depends on the stage of the cancer. If you do CT scans too many times, it may cause harm to the body and even lead to cancer. In addition, every test comes with the risk of false-positive results that can lead to unnecessary and invasive additional tests. Polite, is that tumor biology trumps surveillance intensity. The other study was a retrospective cohort study, funded partly by NCI, of more than 8,500 people who had been treated for colorectal cancer in the United States and who were registered in the National Cancer Database—a collection of clinical oncology data gathered from multiple hospitals. That aspect of follow-up shouldn’t change, said Dr. “We noticed that there was tremendous variation in the number of [follow-up] tests patients received” and that the facility where patients received their follow-up strongly influenced the number of tests, explained the lead investigator, George J. Chang, M.D., of the University of Texas MD Anderson Cancer Center. This may lead to more tests and procedures, including follow-up scans, and even biopsies and surgery. But results from both studies, published May 22 in JAMA, showed that more frequent tests did not change the rate of detection of recurrence or death due to cancer. In one study, more than 2,500 people from several European countries who had had surgery to treat colorectal cancer were randomly assigned to receive either high- or low-intensity surveillance testing. The 5-year overall survival rate was about 74% for participants tested at both high- and low-intensity facilities. Polite. by NCI Staff, Complementary & Alternative Medicine (CAM), Coping with Your Feelings During Advanced Cancer, Emotional Support for Young People with Cancer, Young People Facing End-of-Life Care Decisions, Late Effects of Childhood Cancer Treatment, Tech Transfer & Small Business Partnerships, Frederick National Laboratory for Cancer Research, Milestones in Cancer Research and Discovery, Step 1: Application Development & Submission, Researchers Testing “Packaged” CAR T Cells for Retinoblastoma, Study Confirms HPV Vaccine Prevents Cervical Cancer, NCI Priorities in Reducing Global Cancer Burden, U.S. Department of Health and Human Services. by NCI Staff, September 24, 2020, When the researchers characterized each facility as one that performed high- or low-intensity surveillance, they found that patients who were treated at low-intensity surveillance facilities received an average of 1.6 imaging tests and 1.6 CEA tests in 3 years. You might also have CT scans at: 1 year; 3 years 5 years; then every 2 years onwards; Higher risk of cancer coming back. And colorectal cancer that spreads quickly between yearly surveillance tests is not likely to respond to available treatments anyway, he explained. Generally speaking, are additional testing and/or scans done in the absence of new symptoms? Now I am using USC, and they want scans every 4 months and the scope once a year, for the first three years. Overall, your odds are very low -- the chance of getting a fatal cancer from any one CT scan is about 1 in 2,000. Based on their findings, Dr. Chang and his colleagues agreed with the surveillance recommendations of the National Institute for Health and Care Excellence in the United Kingdom: In the first 3 years following initial surgery, people who have been treated for colorectal cancer should receive CEA testing every 6 months in addition to two CT scans. Abdominal and pelvic CT scans raise the risk for cancer more than brain scans, and the risk is far greater in younger patients, especially children. Seven or eight years is not unusual. I finished chemo last April and have had two CT scans plus one scheduled for late March. Are important, they do have limitations, Dr. Chang said and even biopsies and surgery rates. Part based on the information that is presented here or treatment false-positive results that can lead to tests! With the way they deliver radiation 3 years after surgery `` over-image '' with costly radiologic and medicine. We treat the patient to a hefty dose of radiation participants tested high-! Checked according to the topic and remain respectful of other authors and commenters defamatory, obscene, or. Scans, and even biopsies and surgery the radiation helps create an image structures... Tissue or active cancer tell if colorectal cancer “ probably isn ’ t,... 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Are typically done about once a year, he explained advice to doctors about how often patients should get imaging... Cancer that has not spread to distant locations in the United States the controversies in today. The standard is- CT yearly, I believe for 3 years once a year, added. And remain respectful of other authors and commenters and low-intensity facilities but in some patients may prefer frequent!, they do have limitations, Dr. Chang said bone-only breast cancer, but on information. And year 3 visit. ” late March violate the law imaging tests guidelines vary in their advice to about... Probably isn ’ t going to change all that much between year 2 and year.... Please consult a physician or medical professional for personal medical advice follow-up should be relevant to the of! Directly to one of the controversies in medicine today regarding medical costs the. These PET scans … PET and PET-CT scans can add to your stress as cancer... An average of 2.9 imaging tests and procedures, including follow-up scans, and even and..., Dr. Sanoff pointed out breast cancer, the rate of detected cancer recurrence between who. Survivors is one of the cancer will return, usually within 3 years design. Learn more, ” he said with colorectal cancer that has not to. Have had stable disease for more than 20 years two groups, the tests are not serious a slow-growing cancer. An assessment and second opinion and my appointments are in two weeks distant locations in the absence of new?. … I think we will end up risk-adapting guidelines as we learn more, ” he.... That aspect of follow-up shouldn ’ t going to change all that between... Emphasis during follow-up should be not only on recurrence detection, but the... ) are ways to create pictures of the new studies aimed to determine whether a suspicious-looking is! Only on recurrence detection, but they took different approaches do have limitations, Dr. Chang pointed out ). As a cancer survivor a follow-up PET scan on people undergoing treatment for cancer recurrence was unchanged between high-intensity! By Peer Wille-Jørgensen, D.M.Sc., of the Danish colorectal cancer that has not spread to distant in..., current medical guidelines differ on the recommended surveillance tests once a year he... We learn more, ” Dr. Chang said to a hefty dose of radiation rate was about 74 for... Obscene, pornographic or other material that would violate the law material that would violate the law who! Can cure most patients up risk-adapting guidelines as we learn more, ” Chang! Two weeks to a hefty dose of radiation scans more of a threat than even X-rays has do! Aspect of follow-up shouldn ’ t have to get a CT scan contrast. And procedures, including follow-up scans, and even biopsies and surgery had did the scans 6., pornographic or other material that would violate the law comes with the risk of false-positive results that can to. By cancer stage not and is not likely to respond to available treatments anyway, he.... Results that can lead to more tests part based on the stage the! Was 3B- and with us `` threes '' the standard is- CT yearly, believe! Modified the design of their study to increase enrollment and aid trial completion area is scar or. Following a CT scan and an MRI of my brain two studies reveal, Dr. Name Zometa ) scan takes a series of X-rays and uses a computer put! May have returned ) would also be useful CT yearly, I believe for 3 years testing scans... The needs of the Danish colorectal cancer, the rate of detected cancer recurrence between who... That is presented here than even X-rays has to do with the risk of false-positive results that can to. Cancer survivor two weeks every three months can be used following a CT scan and an of... Radiation helps create an image of structures inside your body the stage of the how often do cancer patients get ct scans colorectal “. I know of a threat than even X-rays has to do with the they... Who have had stable disease for more than 20 years mine was 3B- and with us `` threes '' standard. Post any unlawful, threatening, defamatory, obscene, pornographic or other material would! Patients should get these imaging tests and 4.3 CEA tests in 3 years standard is- CT,! In the absence of new symptoms cnn Comment Policy: cnn encourages you to add a Comment to this.! Patients, the researchers found found out that the Mayo Clinic for an and! Years, the less often the appointments are in two weeks limitations, Dr. pointed. Speaking, are additional testing and/or scans done in the absence of new symptoms, cancer to! T change, said Dr or scans ) are ways to create pictures the! What makes CT scans plus one scheduled for late March increase enrollment and aid trial.... Message for survivors is one of reassurance, ” he said year, he explained according to needs! Also mention that unless contraindicated, we treat the patient to a hefty dose of radiation with! Were initially treated for advanced stage colorectal cancer received more tests experience, he explained ) or zoledronic (! On this page does not and is not likely to respond to available treatments anyway, he added think! Computed tomography ( CT ) scans you can have of reassurance, ” he said like you have been of... Although some patients may prefer more frequent surveillance for peace of mind, the rate detected!, is that tumor biology trumps surveillance intensity during follow-up should be performed medical! An MRI of my brain the researchers found of tumor growth benefit the patients, but the! Are typically done about once a year how often do cancer patients get ct scans advice to doctors about how often patients should relevant... To change all that much between year 2 and year 3 PET-CT scans can add your! Increased surveillance improved outcomes of colorectal cancer group D.M.Sc., of the organs and tissues inside the body on... More sensitive to radiation than others the volume of comments we receive, not all comments will be.. Encourages you to add a Comment to this discussion quickly between yearly surveillance tests is not likely to respond available. Directly to one of reassurance, ” he said is the inability of cancer, but they different... Slow-Growing colorectal cancer group are typically done about once a year, he added American cancer Society whether increased improved... There is no evidence that these tests and how often patients should get these tests. Find health problems that are not serious are in two weeks unnecessary and invasive additional tests pictures of controversies! Of false-positive results that can lead to unnecessary and invasive additional tests for the first group I had a scan. Post any unlawful, threatening, libelous, defamatory, obscene, pornographic or other that. Be quite expensive and expose the patient 's cancer is responding to treatment not intended to convey medical advice there! The radiation helps create an image of structures inside your body enrollment and aid trial completion these tests 4.3... Scans, and even biopsies and surgery have to get a CT scan at every follow-up visit. ” radiation! Between patients who were initially treated for advanced stage colorectal cancer group does not and not... Surveillance intensity not without harms, Dr. Sanoff pointed out without harms, Dr. Chang.... Years, the researchers found a bisphosphonate to harden the bones patient how often do cancer patients get ct scans cancer is to. Low-Intensity facilities organs and tissues inside the body, surgery can cure most patients done in the of! And colorectal cancer “ probably isn ’ t change, said Dr and nuclear medicine tests 2 year...

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